“The Role of Modeling and Simulation in Coordination of Health Care” Dr. Bernard P.Zeigler (SIMULTECH 2014)

Keynote Title: The Role of Modeling and Simulation in Coordination of Health Care

Keynote Lecturer: Dr. Bernard P.Zeigler

Keynote Chair: Dr. Mohammad S. Obaidat

Presented on: 28-08-2014, Vienna, Austria

Abstract: US healthcare, the most expensive in the world, has been diagnosed as an assemblage of uncoordinated component subsystems embedded in a market economy that promotes independent pricing with few points of global control over delivered quality of care and cost. In this talk, we report on a project to develop a modeling and simulation methodology and tools to capture the existing state of, and re-engineer, such a system of systems to increase quality of care and reduce cost. A useful abstraction comprehends the system as an interaction of individual patients, a variety of care providers, a set of payers, and a billing system that records patient-provider transactions and enables payer-provider fee-for-service transactions. Stimulated by the Affordable Care Act and other initiatives, efforts are underway to increase the level of information technology (IT) to improve patient record keeping and portability as well as the move to price services based on performance rather than amount provided. Yet such an IT infrastructure by itself will not provide significantly greater coordination since it does not provide transparency into the threads of transactions that represent patient treatments, their outcomes, and total costs.
In this talk, we discuss the Pathways Care Coordination model, a construct that enforces threaded distributed tracking of individual patients experiencing certain pathways of intervention, thereby supporting coordination of care and fee for performance based on end-to-end outcomes. As an essential byproduct, the Pathway concept also opens up possibilities for system level metrics that enable more coherent visualization of behavior than previously possible, therefore greater process control and improvement re-engineering, We discuss the associated concepts, their implementation in the MS4 Modeling and Simulation Environment, and the application to a successful implementation of Pathways model in a local scale. We close with comments on how the environment and tools can play a role in the evolution of the Pathways model as it is scaled up to state and national levels.

Presented at the following Conference: SIMULTECH, International Conference on Simulation and Modeling Methodologies, Technologies and Applications